Subcutaneous Manicka Zone Pacing for Ventricular Synchrony

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Solution Overview

Problem

Traditional cardiac pacing methods, such as right ventricular and biventricular pacing, suffer from electrical and mechanical dyssynchrony, requiring complex procedures and increasing the risk of complications, while bundle branch pacing is limited by invasive lead implantation.

Innovation Solution

A subcutaneously implantable device is anchored to the xiphoid process or sternum, with prongs extending to the Manicka Zone of Pacing, defined 3 cm laterally from the left anterior descending artery, to synchronize pacing of the right and left ventricles without vascular leads.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of manufacture

If right ventricular pacing is used, then the pacing procedure is simple and well-established, but electrical and mechanical dyssynchrony occurs leading to pacing-induced cardiomyopathy

Engineering Contradiction:

Improvepacing procedure simplicityVSAvoidcardiac synchrony

Core Design Contradiction:

Ease of manufactureVSReliability

Solution Approach 1:

Instead of pacing the right ventricle apex (traditional approach), the invention inverts the approach by pacing the left ventricular free wall at the Manicka Zone. This inversion allows activation to spread naturally to the right ventricle, achieving synchrony without the dyssynchrony problems of traditional RV pacing.

Inventive Principle:

Principle #13The other way round (Inversion)

Solution Approach 2:

The invention applies local quality by specifically targeting the left ventricular free wall at the Manicka Zone (3 cm from LAD) for pacing, rather than using general RV apical pacing. This localized approach creates optimal activation patterns that propagate through the ventricles to achieve synchronous contraction.

Inventive Principle:

Principle #3Local quality

2Reliability

If biventricular pacing is used, then cardiac synchrony is improved, but the procedure complexity increases and stroke risk increases due to requiring three leads

Engineering Contradiction:

Improvecardiac synchronyVSAvoidnumber of leads required

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The invention extracts and eliminates the need for multiple leads by using a single lead placed in the left ventricular free wall at the Manicka Zone. This single lead placement provides both right and left ventricular pacing functions, removing the complexity of managing three separate leads while maintaining cardiac synchrony.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The single lead placed at the Manicka Zone serves multiple functions: it provides left ventricular pacing, right ventricular pacing through natural activation spread, and cardiac resynchronization therapy. This multi-functionality eliminates the need for separate leads for each function.

Inventive Principle:

Principle #6Universality (Multi-functionality)

3Reliability

If bundle branch pacing is used, then cardiac synchrony is achieved, but invasive lead implantation into the interventricular septum is required

Engineering Contradiction:

Improvecardiac synchronyVSAvoidinvasive lead implantation risk

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

Instead of directly pacing the bundle branches through invasive septal penetration, the invention creates a copied effect by pacing the left ventricular free wall at the Manicka Zone. This location allows natural electrical spread that replicates the synchronizing effect of bundle branch pacing without the invasive septal implantation risks.

Inventive Principle:

Principle #26Copying

4Reliability

If traditional pacing approaches are used, then vascular leads are required for implantation, but this increases procedural complexity and complication risks

Engineering Contradiction:

Improvepacing efficacyVSAvoidvascular lead implantation procedure

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The invention extracts and eliminates the requirement for vascular lead implantation by using a transvenous approach that places the lead in the left ventricular free wall through venous access. This removes the need for complex vascular puncture and septal penetration procedures while maintaining pacing efficacy.

Inventive Principle:

Principle #2Taking out (Extraction)

Data Source

PatentUS20260021294A1Manicka zone of pacing

Publication Date: 2026.01.22 MANICKA INSTITUTE LLC

AI summary

A method of pacing a heart includes implanting a subcutaneously implantable device on a xiphoid process and/or a sternum of a patient. The subcutaneously implantable device includes a housing, a prong extending away from the housing, and a first electrode at a distal end of the prong. The method further includes contacting a Manicka Zone of Pacing on an anterior surface of the heart with the first electrode on the distal end of the prong. The Manicka Zone of Pacing is defined as an area of the heart extending 3 centimeters (1.1811 inches) laterally outward from either side of a left anterior descending artery of the heart. A pacing signal is delivered to the Manicka Zone of Pacing of the heart through the first electrode. A right ventricle and a left ventricle of the heart are synchronously paced with the pacing signal received in the Manicka Zone of Pacing.